chest discomfort Flashcards
(34 cards)
high % of patients diagnosed with nontraumatic acute chest pain
gastrointestinal 42%
ischemic heart disease 31%
chest wall syndrome 28%
pericariditis 4%
precipitated by an imbalance between myocardial O2 requirements and myocardial O2 supply, resulting in insufficient delivery of O2 to meet the metabolic demands
myocardial ischemia / angina pectoris
what determines the myocardial O2
by the coronary blood flow and coronary arterial O2 content
end result of angina pectoris
myocardial infarction (heart attack)
caused by atheromatous plaque that obstruct one or more of the epicardial coronary arteries
ischeming heart disease
result from the gradual atherosclerotic narrowing of the coronary arteries
stable ischemic heart disease
is unstable ischemic heart disease
no detectable acute myocardial injury
may also have non-ST elevation MI
unstable angina
characterized by ischemic episodes that are typically precipitated by a super imposed disease in O2 demand during physical exertion and relived upon resting
stable angina pectoris
involvement of the pericardium due to infectious or non infectious cause
arise from associated pleural inflammation which is exacerbated by breathing, coughing and position
pericardial
acute aortic syndrome
chest pain lcoated in the middle of the chest
ascending aorta
acute aortic syndrome
pain in the back aortic aneurysm
most often asymptomatic
descending aorta
Q - pressure, tightness, squeezing, heaviness, burning
L - retrosternal, often radiation to neck, jaw, shoudlers, or arms, sometimes epigastric
AF - mitral regurgitation during pain
myocardial ischemia
Q - pleuritic, sharp
L - retrosternal or toward cardiac apex; may radiate to left shoulder
AF - may be relived by sitting up and leaning forward; pericardial friction rub
pericarditis
Q - tearing or ripping; knifelike
L - anterior chest, often radiating to back, between shoulder blades
AF - associated with hypertension and/or underlying connective tissue disorder; murmur or aortic insufficiency; loss of peripheral pulses
acute aortic syndrome
Q - pleuritic; may manifest as heaviness with massive pulmonary embolism
L - often lateral, on the side of the embolism
AF - dyspnea, tachypnea, tachycardia and hypotension
pulmonary embolism
Q - pressure
L - substernal
AF - dyspnea, signs of increase venous pressure
pulmonary hypertension
Q - pleuritic
L - unilateralm often localized
AF - dyspnea, cough, fever, rales, occasional rub
pneumonia or pleuritis
Q - pleuritic
-L - lateral to side of pneumothorax
AF - dyspnea, decreased breath sound on the side of pneumothorax
spontaneous pneumothorax
most common symptoms needs immediate attention, hence its emergency situation for confinement
chest discomfort
masnifestation of angina pectoris when there is increase myocardial consumption
increased HR, ventricular wall stress and contractility
is characterized by ischemic episodes that are typically precipitated by a super imposed increase in O2 demand during pyhsical exertion and relived upon resting
stable angina
physical examination
anxiety
uncomfortable
diaphoretic
cyanotic
general observation
physical examination
hypotension
increase heart or pulse rate
fever
tachypnea or dyspnea
vital signs
